Who gets the bed?

Who should have a ventilator?

Who gets priority for the U.

K's 240,000 doctors will be down to them to decide on while they wait for the government to issue official guidelines.

The British Medical Association have given their own advice to doctors today.

These are the worst case scenarios they may be thinking about in the weeks ahead.

Doctors used to making life and death decisions, but in a pandemic, if the system is under intense pressure, what should they do that they're professional association has come up with these guidelines to help in some of the most challenging decisions they'll have to make when it comes to age, The BM A says a cutoff would be unlawful.

But older patients with severe respiratory failure may have a very high chance of dying on would be lower priority for admission to intensive care.

Patients who were ill in the early stages of the pandemic are more likely to be cared for in intensive care and get a ventilator than those who become similarly ill later.

The Be Emma also says that we may reach a stage where priority over treatment would be given two essential workers to keep the health service and other key sectors running on limit economic losses.

But they say it's up to the government to decide who these people are and not doctors.

Thes decisions have already been made in countries which have had high numbers of deaths from covert 19 like it's the China and Spain.

Medical ethics expert Dr Jonathan Ives welcomes the advice.

So I think it is certainly a good idea to have this times out of people have time to digest it so that there's time to have a public conversation about it's.

It's very important public are aware of now involved in these kinds off this discussions and decisions as far as we're still waiting on the government here in the UK to issue their guidance on what doctors will potentially have to do.

Likewise, updated advice on who gets personal protection equipment is still an issue yet to be tackled by them.

Currently, only people dealing with covert 19 patients have high priority over this equipment on the front line in hospital should be wearing a P R sort of times.

That's really important because it is now clear, very clear, that there are a lot of patients that are asymptomatic, which means they have no symptoms whatsoever that are able to transmit virus As the pandemic progresses, unions for health care workers are looking to the government to give them clear guidelines on how to make some of these tough decisions.

I should tell reporting while joining me now from London is Julian she there, a special advisor in ethics on human rights to the British Medical Association.

People will wonder what this means in real terms Doesn't mean that if you have a potentially life limiting condition, whether it's heart disease or something else, doctors would be correct to put you further down the list of priorities for treatment.

When it comes down to it, I think it's absolutely essential that we recognize that nobody wants to be making these kinds of decisions.

But if we do get to a situation where resources are absolutely overwhelmed by need, the question of rises is what does fairness in the distribution of those life saving interventions look like on one of the issues that will be put into place are questions around capacity to benefit, as I say, to repeat, if if, If.

If, If resources are overwhelmed, questions about how to prioritize how best to distribute those resources become urgent now, the guidelines say it shouldn't just mean that age means that you don't get treated absolutely but absolute.

What scenario would older person be prioritized over a younger person?

If, for example, the older person was fit and healthy and the younger person had underlying co morbidity is that meant they were very unlikely to benefit from the intervention than the older person would be prioritized?

What we're interested in is identifying clinically relevant factors for the distribution of these resources.

Age in and of itself will not be a clinically relevant factor unless it is associated with underlying morbidity.

I mean, how helpful do you think this is a public debate?

I mean, do you actually want people to think about whether they should be going to hospital themselves?

Is that is that kind of what the purpose of this is for families to decide whether they should try and go into intensive care or whether they should actually die at home.

I mean, the guidance is both for its principally faced towards medical professionals trying to support to medical professionals.

When they are confronting these incredibly harrowing decisions, they don't want to make them.

Nobody wants to be here.

I also think it's Z.

It's an excellent idea that people decide in advance how they might like to be treated if the's circumstances arise.

It's a matter of individual choice and freedom and autonomy.

Andi.

I mean, we strongly recommend that people start having those conversations.

Now.

Do doctors want a firm set of guidelines to be handed down to them?

Or are they happier working within the framework they've always worked with on with these sorts of guidelines themselves?

One of the things that we want to ensure where a number of things you want to ensure we want to ensure that doctors are supported feel confident when they are forced to make these harrowing decisions.

If we can get centralized advice and guidance from the government that our guidance Kenly lock into, then so much the better.

It's far better if the government and the professions speak with a single voice on these issues that will give confidence to doctors, and it'll give confidence to patients that these decisions that made as fairly as possible in these demanding circumstances.